Inspection on 19/01/09 for Ings House Nursing Home

This inspection was carried out on 19th January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ings House Nursing Home 12/12/06

Ings House Nursing Home 19/12/05

Ings House Nursing Home 14/07/05

Ings House Nursing Home 25/01/05

Ings House Nursing Home 21/10/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ings House Nursing Home 350 Bradford Road Liversedge West Yorkshire WF15 6BY     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Karen Summers     Date: 1 9 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Ings House Nursing Home 350 Bradford Road Liversedge West Yorkshire WF15 6BY 01924411166 01924410131 ken.woolford@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr John Keen Name of registered manager (if applicable) Mr Kenneth Royston Woolford Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Ings House care home was built in the early 1800s and was extensively renovated and refurbished in 1990, when it was converted for use as a nursing home. It is situated just off a main road from Heckmondwike to Cleckheaton and it is convenient for those travelling on public transport. Shops and local amenities are located fairly closely within 5 minutes walking distance. The home offers single and twin accommodation, some with en-suite facilities for up to 32 elderly people. The registered manager informed the Commission for Social Care Inspection on 19/01/09 that fees range from £358.18 to £530.73 per week. Additional charges include hairdressing, private chiropody, newspapers, clothing, dry cleaning and personal toiletries. Information about the home and the services provided are available from the home in the statement of purpose and service users guide. Care Homes for Older People Page 4 of 26 care home 32 Over 65 31 0 0 1 Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection of this service was completed on the 12th December 2006. The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This report refers to an inspection, part of which included an unannounced visit on the 19th January 2009, commencing at 9am, and the length of the visit was 6 hours. There were 32 people living at the home on the day of the visit. During the visit we spoke with members of staff, relatives and people who receive care Care Homes for Older People Page 6 of 26 to obtain their views. We also looked at a sample of care records, staff recruitment and training records; quality assurance audits and looked around the home. To enable people who use the service to comment on the care it provides, we sent surveys to 10 people who live at the home, 10 of which were retuned, 10 to staff, and 5 to local doctors and health care workers (social workers, pharmacist, community nurses etc.), all of which were returned. The comments in the surveys were positive about the standard of care provided by the staff at the home. The provider informed the Commission for Social Care Inspection on the day of the visit that fees range from three hundred and fifty eight pounds and eighteen pence to five hundred and thirty pounds and seventy three pence. Additional charges include hairdressing, private chiropody, newspapers, clothing, dry cleaning and personal toiletries. We would like to thank all people who gave feedback about the home, and would like to thank the manager and staff for their co-operation throughout the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed prior to them moving into the home to ensure that their needs can be met, and are able to visit the home to establish whether or not it is the right place for them. Evidence: The information received from the home prior to inspection said that they encourage prospective people who use the service and their families, to visit the home and spend some time there speaking to visitors and people who live there, to gain an insight of how they view the service. The records of three people were looked at, all of which contained a pre admission assessment carried out by the home, and the funding local authority. People living in the home confirmed that they had received enough information about Care Homes for Older People Page 11 of 26 Evidence: the home before they moved in so they could decide if it was the right place for them. A relative commented in the survey, As a family were were impressed by the level of information that we received and the advice and support given. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care plans outline the level of support and care each person requires in ensuring their health and welfare needs will be met. The recording and administration of medication is satisfactory. People are treated with respect. Evidence: Three peoples care plans were seen, and there was evidence to suggest that people receive personal and healthcare support in a person centred way, and that their social, cultural, religious needs, and likes and dislikes were recorded. There was also information in the care records of involvement from peoples doctors, social workers, opticians and other health care professionals where needed. Care reviews had taken place, and the care plans had been updated monthly or as the needs of the person changed, and this was with the involvement of the person or their relative. Seven out of ten people who use the service said that they receive the care and Care Homes for Older People Page 13 of 26 Evidence: support they need. Three people said, Usually, and one person said, Sometimes. Everyone said that staff listen and act on what they say, and were available when they need them. One person said, The staff are very helpful and if they are unsure, will find out from other sources. A relative of a person made the comment, My wife is very well cared for at Ings House Nursing Home and I am more than happy with the staff and my wifes care. Comments from health care professionals (doctors, pharmacist, social workers etc.) include, They know their residents needs well and follow the plan of care, seeking assistance when unsure. Another person said that people are allowed to get up and go to bed at the time they did in their own homes. The same person said, Care plans well written to meet individual needs. A sample of three peoples medication and records were checked. The storage, administration and recording of the medication were done correctly. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are living at the home are offered a range of activities that they can take part in. Meals provided are varied and nutritious. Evidence: Two people are responsible for providing activities between 8.30am and 3pm over a six-day period. One person works four days a week, and the second person, two days a week. Within the care records, staff had recorded the individual persons likes and dislikes, and there was also a record of their previous hobbies and interests. The activities person wrote on a daily basis when a person had taken part in an activity however, as this information had been recorded in the daily record, the information was not always clearly identified. Following discussion with the manager, it was decided that the information would be recorded more clearly to make it more identifiable. We also discussed with the manager that a programme of activities should be displayed to ensure that people know what activities are taking place that day. At the time of the visit people were seen taking part in board games, talking to other Care Homes for Older People Page 15 of 26 Evidence: people, visitors and staff and generally passing the time of day. People were asked, Are there activities arranged by the home that you can take part in? Three people said that there were always activities that they could take part in. Three people said that there usually were. One person said sometimes, and one person said that they were too poorly to attend any activities. The health professionals survey asked, How do you think the care service can improve? One person said, Therapeutic activities meaningful and age related on a regular rota. The menus offered a variety of food, and following a meeting with the relatives/ people who live at the home, the menus were displayed in the corridor of the entrance to the home. The manager said that on a daily basis a member of staff goes round to everyone in the home and asks them if they would like the meal on offer. The manager also said that should someone not like the meal available, then an alternative would be offered. Discussion was held regarding offering a choice at meal times. Without exception people who use the service said in the surveys that they liked the meals at the home. One person made the comment,The meals are always good and healthy. Two relatives who were visiting at the time of the inspection, also said that the food was good, and that they are offered meals when visiting their relative which are free of charge. As a tribute to the standard of food provided the home has received a five star, Very Good award in association with Kirklees Councils Choice Award, Scores on the doors Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their complaints will be listened to and acted upon. Unless all staff have safeguarding training people could be potentially at risk of abuse. Evidence: The home has a complaints procedure and the manager confirmed that a copy of the procedure is made available to people living at the home and their relatives. Discussion was held about displaying the procedure in the entrance of the home for visitors to see should they need to make a complaint. The manager also said that he has an open door policy for relatives and visitors to see him on a daily basis should they have any concerns. In addition to this, the manager visits every person living in the home daily, and people living there confirmed this. One person said, The manager comes around the home most days and asks if we are ok. People said that they knew who to speak to if they were not happy however, four out of ten people did not know how to make a complaint. There was evidence in the training records to suggest that seven staff have not had safeguarding (adult protection) training that provides information on how to protect people from abuse. The manager said that he had recently had the training, and that he had also identified three training dates when all staff would have the training. Care Homes for Older People Page 17 of 26 Evidence: The manager was in the process of updating his safeguarding procedure to reflect his training and the procedure/policy from Kirklees Council. Staff who were spoken with said that they were aware of the procedure to follow if they suspected abuse of a person. Care Homes for Older People Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers people a homely, comfortable and clean environment. Evidence: As part of the inspection a tour of the home took place, which included the communal areas and a number of bedrooms. Ongoing refurbishment continues to take place, and includes the purchase of specialised mattresses, beds, furnishings and carpets. The manager said that he visits the home each day and ensures that standards are maintained. The staff and people living at the home also confirmed this. The standard of cleanliness throughout the home was good, and systems are in place to control the spread of infection. Without exception, people commented in the surveys that the home is always fresh and clean. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by qualified, experienced staff in sufficient numbers, and that has had all the necessary checks before working with people so that they are kept safe. Evidence: The duty rota confirmed that there were sufficient staff on duty to care for the number of people living at the home, and the manager confirmed this. When asked if the care staff have the right skill and experience to look after people properly, health care professionals, (Dietician, Pharmacist and Social workers,) replied, Always One person said that the care staff are very aware of the needs of people in their care. Care practice observed during this visit, and the relationship between staff and people being cared for was positive. A sample of recruitment records was inspected and they contained the required information and employment checks. These checks are necessary to help protect people from potentially unsuitable staff. There was also evidence in the staff records and staff confirmed that they had induction training when they came to work at the home, which provides them with the Care Homes for Older People Page 20 of 26 Evidence: knowledge and skill to look after people in their care. The manager has recently had training relating to dementia care, and arranging further training for the staff to attend. A qualified nurse is on duty twenty four hours a day. Forty two percent of care staff have an NVQ (National Vocational Qualification) level two or above in care, and a further four staff are to be enrolled on the course. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is of good character, and is competent to run the home. Peoples financial interests are protected, and the home is run in the best interest of people living there. Without staff being kept up to date in movement and handling practices, people and staff could be potentially put at risk. Evidence: The manager has a number of years experience of working at the home and has completed the Registered Managers Award, and an NVQ level 4 in Management and Social Care Organisations. Staff and people living at the home spoke positively about the approach of the manager and how he is available should they need to speak with him. An annual quality monitoring survey is carried out which includes people who live at Care Homes for Older People Page 22 of 26 Evidence: the home and their relatives. The results of the survey are made public and an action plan is developed to address any issues identified. The results of the survey from August 2008 were seen and were positive. The home does not hold personal monies on behalf of people. Should they require any money then it is supplied by the home and re charged to the persons monthly bill. Discussion was held with the manager of the need for staff to have supervision a minimum of six times a year to ensure that they are competent to do their job. The manager said that he would ensure that regular supervision takes place for all care staff. Routine health and safety and maintenance are carried out and appropriate records were seen of those looked at. Records were also seen of fire alarm and emergency lighting tests. Fire drills had also been carried out and staff confirmed that they had received training. However, the records showed that staff had received one fire lecture in the year. Following consultation with the fire safety officer, he confirmed that it is good practice to have two fire lectures a year. It is also good practice to have regular fire drills. According to the training records and also confirmed by staff that they have not had movement and handling training annually. This was discussed with the manager and at the time of the inspection he arranged up date training for all the staff. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 A programme of activities should be made available to ensure that people know what activities are taking place each day. All staff to have safeguarding training to protect people from potential abuse. A minimum of 50 of care staff should have an NVQ 2 in care or an equivalent qualification, as qualified staff have a better understanding of peoples needs. To ensure that staff are up to date with fire procedures it its good practise for them to have regular fire lectures and drills. All staff are to have annual movement and handling training to make sure that they are aware of current practise, and therefore reduce the risk and injury to themselves and people in their care. 2 3 18 28 4 38 5 38 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!